Page 13 - Virtual Vascular Vol 10

Intramural Hematoma

Lai Kam Chuen IMH.mp4

62 years old man, known hypertensive. Admitted to CCU on 17th April 2021 with acute
chest pain. CT showed 4cm ascending aorta, an INTRAMURAL HEMATOMA from distal
arch to the descending aorta and a small penetrating ulcer in the arch. A full dissection
flap was visible starting in the paravisceral aorta, extending to left common iliac artery.
All viscerals from true lumen with no malperfusion.

This patient can be managed conservatively, but the intramural hematoma is quite size-
able. There is a risk of conversion into a full dissection and an early follow up CT scan is
recommended.

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